Examining the relationships between changes in the characteristics, inputs or activities of state health departments and health outcomes

The Foundation's Public Health Systems Research program was designed to help establish the field of public health systems research as a needed resource that will enable governmental health agencies to improve their performance. The principal objectives of this grant are to identify characteristics, inputs, or activities of state health departments and state public health systems that may account (at least in part) for changes in health outcomes. The grant will involve using secondary data from the State Assessment Tool of the Public Health Performance Standards program and from America's Health Rankings. Researchers will examine the relationships between changes in characteristics, inputs, and activities of state health departments (SHDs) and state public health systems, and changes in state-level health outcomes over the past 15 years. Researchers will also examine how states have responded to America's Health Ranking (AHR) reports in order to explore whether policy translates into action with positive effects on health outcomes. The overarching questions to be examined are: (1) Why have some states made significant improvements in the AHR rankings, while others have not? (2) What is the association between these changes in health outcomes and state public health systems performance? and (3) How have SHDs responded to the AHR reports, and can we identify any specific changes in characteristics, inputs, and activities that might explain changes in health outcomes during the time frame of the reports (1990-2007)? The objective of this project is to provide a clearer evidence-base for public health practice by effectively showing how state-level changes in inputs, processes, and outputs are connected to health outcomes.